PurposeBone is the most frequent site of metastasis among breast cancer patients. We investigated prognostic factors affecting survival following bone-only metastasis in breast cancer patients.Materials and MethodsThe medical records of breast cancer patients who were treated and followed at Gangnam Severance Hospital retrospectively reviewed to identify patients with bone-only metastasis.ResultsThe median time from the diagnosis of bone-only metastasis to the last follow-up or death was 55.2 [95% confidence interval (CI), 38.6-71.9] months. The Kaplan-Meier overall survival estimate at 10 years for all patients was 34.9%. In the multivariate Cox regression model, bisphosphonate treatment [hazard ratio=0.18; 95% CI, 0.07-0.43], estrogen receptor positivity (hazard ratio=0.51; 95% CI, 0.28-0.94), and solitary bone metastasis (hazard ratio=0.32; 95% CI, 0.14-0.72) were significantly associated with longer overall survival in the bone-only recurrence group. Among the treatment modalities, only bisphosphonate treatment was identified as a significant prognostic factor.ConclusionIdentifying the factors influencing breast cancer mortality after bone-only metastasis will help clarify the clinical course and improve the treatment outcome for patients with breast cancer and bone-only metastasis. Bisphosphonates, as a significant prognostic factor, warrant further investigation.

BackgroundThis study examined the results of open wedge high tibial osteotomy with using an Aescula open wedge plate and an allogenic bone graft as a surgical technique for the patients who suffer from osteoarthritis of the knee with a genu varum deformity.MethodsFrom March 2007 to August 2007, 33 patients (37 cases) with osteoarthritis of the knee and a genu varum deformity underwent a high tibial osteotomy with using an Aescula open wedge plate and an allogenic bone graft. The patients were followed up for more than 1 year. Before and after surgery, the correction angle of the genu varum was measured by the lower extremity scannogram and the posterior tibial slope, the joint space distance and the time to bone union were evaluated. The functional factors were evaluated using the Knee Society Score.ResultsThe average knee score and function score improved from 52.19 ± 11.82 to 92.49 ± 5.10 and 52.84 ± 6.23 to 89.05 ± 5.53, respectively (p < 0.001). According to the lower extremity scannogram, the mean preoperative varus angle was -1.86 ± 2.76°, and the average correction angle at the last follow-up was 10.93 ± 2.50° (p < 0.001). The tibial posterior slope before surgery and at the last follow-up were 8.20 ± 1.80° and 8.04 ± 1.30°, respectively (p = 0.437). The joint space distance increased from 4.05 ± 1.30 mm to 4.83 ± 1.33 mm (p < 0.001). The average time to complete bone union was 12.69 ± 1.5 weeks.ConclusionsAn open wedge high tibial osteotomy using an Aescula open wedge plate and an allogeneic bone graft to treat osteoarthritis of the knee with a genu varum deformity showed good results for the precision of the correction angle, the time to bone union and the functional improvement.

To examine the morphological changes of the medial meniscus in advanced knee osteoarthritis (OA) we examined 167 knee joints of 106 patients who subsequently underwent total knee joint arthroplasty from January to May, 2007. All 106 patients were females and their ages ranged from 57 to 83 years (mean 68.7 +/- 5.6 years). For patients with complete loss of medial joint space by weight-bearing radiography, the meniscal position was assessed by measuring meniscal subluxation and meniscal height. Meniscal morphology was assessed using a modified WORMS MRI-based method. Description of the prevalence of different meniscal morphologies and their respective positions are presented. The predominant type (32.2, 64.1 and 83.8% in anterior horn, mid-body and posterior horn, respectively) of meniscal morphology abnormality was a hypertrophied displaced tear. Medial meniscus height was found to be higher than lateral meniscus height. In persons with an hypertrophied meniscus the height of the medial meniscus was 8.06 +/- 1.15, 10.03 +/- 1.79, and 8.61 +/- 1.57 mm at anterior horn, mid-body and posterior horn, respectively, compared to those in other categories whose height was 6.04 +/- 0.92, 5.08 +/- 1.68 and 6.43 +/- 1.26 mm. A large proportion of persons with end stage varus knee OA have a paradoxically hypertrophied medial meniscus. This new finding of hypertrophied menisci highlights that not all menisci in persons with end stage OA are macerated or destroyed.

LR is a feasible and effective surgical treatment for patients with small-sized and antimesenteric-sided duodenal GIST in terms of late complications and postoperative diabetic complications. MI-LR has better perioperative outcomes than open LR. Therefore, we should consider MI-LR as an optimal surgical treatment for selected patients with duodenal GIST.